Overview

A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening. When panic attacks occur, you might think you're losing control, having a heart attack or even dying.

Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends. But if you've had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, you may have a condition called panic disorder.

Although panic attacks themselves aren't life-threatening, they can be frightening and significantly affect your quality of life. But treatment can be very effective.

Symptoms

Panic attacks typically begin suddenly, without warning. They can strike at any time — when you're driving a car, at the mall, sound asleep or in the middle of a business meeting. You may have occasional panic attacks or they may occur frequently.

Panic attacks have many variations, but symptoms usually peak within minutes. You may feel fatigued and worn out after a panic attack subsides.

Panic attacks typically include some of these symptoms:

Sense of impending doom or danger

Fear of loss of control or death

Rapid, pounding heart rate

Sweating

Trembling or shaking

Shortness of breath or tightness in your throat

Chills

Hot flashes

Nausea

Abdominal cramping

Chest pain

Headache

Dizziness, lightheadedness or faintness

Numbness or tingling sensation

Feeling of unreality or detachment

One of the worst things about panic attacks is the intense fear that you'll have another one. You may fear having a panic attack so much that you avoid situations where they may occur.

When to see a doctor

If you have panic attack symptoms, seek medical help as soon as possible. Panic attacks, while intensely uncomfortable, are not dangerous. But panic attacks are hard to manage on your own, and they may get worse without treatment.

Because panic attack symptoms can also resemble other serious health problems, such as a heart attack, it's important to get evaluated by your health care provider if you aren't sure what's causing your symptoms.

Causes

It's not known what causes panic attacks or panic disorder, but these factors may play a role:

Genetics

Major stress

Temperament that is more sensitive to stress or prone to negative emotions

Certain changes in the way parts of your brain function

Panic attacks may start off by coming on suddenly and without warning, but over time, they're usually triggered by certain situations.

Some research suggests that your body's natural fight-or-flight response to danger is involved in panic attacks. For example, if a grizzly bear came after you, your body would react instinctively. Your heart rate and breathing would speed up as your body prepared itself for a life-threatening situation. Many of the same reactions occur in a panic attack. But it's not known why a panic attack occurs when there's no obvious danger present.

Risk factors

Symptoms of panic disorder often start in the late teens or early adulthood and affect more women than men.

Factors that may increase the risk of developing panic attacks or panic disorder include:

Family history of panic attacks or panic disorder

Major life stress, such as the death or serious illness of a loved one

A traumatic event, such as sexual assault or a serious accident

Major changes in your life, such as a divorce or the addition of a baby

Smoking or excessive caffeine intake

History of childhood physical or sexual abuse

Complications

Left untreated, panic attacks and panic disorder can affect almost every area of your life. You may be so afraid of having more panic attacks that you live in a constant state of fear, ruining your quality of life.

Complications that panic attacks may cause or be linked to include:

Development of specific phobias, such as fear of driving or leaving your home

Frequent medical care for health concerns and other medical conditions

Avoidance of social situations

Problems at work or school

Depression, anxiety disorder and other psychiatric disorders

Increased risk of suicide or suicidal thoughts

Alcohol or other substance misuse

Financial problems

For some people, panic disorder may include agoraphobia — avoiding places or situations that cause you anxiety because you fear not being able to escape or get help if you have a panic attack. Or you may become reliant on others to be with you in order to leave your home.

Prevention

There's no sure way to prevent panic attacks or panic disorder. However, these recommendations may help.

Get treatment for panic attacks as soon as possible to help stop them from getting worse or becoming more frequent.

Stick with your treatment plan to help prevent relapses or worsening of panic attack symptoms.

Get regular physical activity, which may play a role in protecting against anxiety.

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